At Children’s, we treat a wide range of hip conditions in kids from birth to young adulthood. Even if your child doesn’t show signs of a hip condition, there are things parents can do to promote overall hip health—and misconceptions parents might not have to worry about after all. Tim Schrader, MD, Medical Director of the Hip Program at Children’s, has a few tips for keeping young hips healthy at any age or stage of development.
1. Babies: Hip-healthy swaddling
Parents of infants can support proper hip development by using hip-healthy swaddling methods that do not restrict the hip joints. According to Dr. Schrader, a baby’s legs should be able to bend up and out at the hips in a frog-like position. Likewise, any baby carriers or wraps parents use should support the child’s legs under the thighs and keep the knees apart rather than leave the legs dangling.
Hip-safe swaddling and baby carriers can contribute to healthy hip development and lower the risk of hip dysplasia, or developmental dysplasia of the hip (DDH). This condition, in which the hip joint is unstable or underdeveloped, is often present at birth due to the position of the baby in the womb or a family history of hip dysplasia, but it may also appear after birth or during early childhood.
2. Young children: “W sitting” is OK
Many kids like to sit with their knees in front and feet out to either side in a position called W sitting—and many parents of young kids may recall being scolded by their own pediatricians decades ago for doing the same thing. In general, Dr. Schrader says, there is no evidence that shows W sitting causes orthopedic issues down the road. Children will sit in whatever position is easy and comfortable for them, and that’s OK.
“What I tell parents is, if you don’t like it, then correct your child. If they correct easily, that’s fine,” Dr. Schrader says. But he also advises parents to pick their battles: “If it’s a source of conflict, angst or fighting, then I don’t think it’s worth that kind of a problem.”
3. Growing athletes: Mix it up, but don’t skip the warmup or cool-down
As kids get older and start to focus on sports, many doctors will warn against specializing in a sport too soon. No matter what sport a young athlete is into, Dr. Schrader recommends cross-training or otherwise taking a break from the primary sport as a good way to keep hips healthy and avoid injury.
“It’s better to be a well-rounded athlete and not a year-round single-sport athlete. I think diversification is good to make sure kids don’t overuse one muscle group or joint.” – Tim Schrader, MD, Medical Director, Hip Program
“It’s better to be a well-rounded athlete and not a year-round single-sport athlete,” Dr. Schrader says. “I think diversification is good to make sure kids don’t overuse one muscle group or joint.”
Stretching, warming up and cooling down before and after any workout is just as important as mixing things up—particularly if the kid is not very flexible or has had some overuse-related conditions. Coaches may not want to dedicate a lot of already limited practice time to this, so athletes should try to do some of this at home. In some cases, the best hip stretches do not stretch the hips at all: Dr. Schrader points to the hamstrings, glutes, abdominals and obliques as crucial muscle groups that should be warmed up to support the hips.
4. Kids and teens: Pay attention to pain
Hip aches and pains in children and adolescents—and even adults—are not always what they seem. According to Dr. Schrader, problems with the hips are often felt in the thigh or knee. This is known as referred pain, which is when the pain you feel in one part of your body is actually caused by pain or injury elsewhere. In his practice, he sees it often in kids who have Legg-Calvé-Perthes disease or slipped capital femoral epiphysis (SCFE), but it’s important for everyone to be aware of the possibility that pain they’re feeling somewhere else in their body might actually be coming from their hips.
“Listen to your body. If something is hurting day after day after day, it may not be just sore muscles.” – Tim Schrader, MD, Medical Director, Hip Program
“Listen to your body,” Dr. Schrader says. “If something is hurting day after day after day, it may not be just sore muscles.” It could be referred pain or an early sign of an overuse injury, and it may need to be checked out by a doctor.
5. Early diagnosis is best
As with most conditions, early diagnosis is best for keeping hips healthy and avoiding or reducing later problems. Communication between kids, parents and their doctors is key to making sure children get any medical attention they need to keep their hips healthy.
“If parents truly think something is going on, then they should go to someone who’s an expert in the field,” Dr. Schrader says. “Parental intuition is quite good.”
Tim Schrader, MD, is the Medical Director of the Children's Hip Program. Combining the training he received at Harvard Medical School (working with Dr. Michael Millis and Dr. Young-jo Kim) and the Müller Foundation in Switzerland (working with Professor Reinhold Ganz), Dr. Schrader developed a special interest in pediatric, adolescent and young adult hip preservation and hip problems, including hip dysplasia. Dr. Schrader is the only International Hip Dysplasia Institute (IHDI) provider in Georgia. IHDI physicians are those who participate in IHDI efforts with contributions above and beyond direct patient care for the advancement of hip dysplasia advocacy, research and education.
This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on Children’s Healthcare of Atlanta team are independent providers and are not our employees.